Can MRI See the Future? Predicting Crohn’s Response with Imaging
🧠 Predicting Long-Term Response in Crohn’s Disease with DWI MRI
Hi Everyone,
This month we’re spotlighting a fascinating study that delves into the role of diffusion-weighted imaging (DWI) MRI in predicting long-term treatment outcomes for patients with Crohn’s disease.
📝 Study Overview
Title: Diffusion-weighted imaging to predict longer-term response in Crohn’s disease patients commencing biological therapy: results from the MOTILITY trial
Authors: Maira Hameed et al.
Journal: British Journal of Radiology, Vol. 98, Issue 1168 (2025)
🔍Background
Crohn’s disease is a chronic, relapsing inflammatory bowel condition. Predicting which patients will respond to biological therapy remains a key clinical challenge. Conventional biomarkers such as CRP and fecal calprotectin often fall short in forecasting long-term outcomes. This study explores whether early changes in DWI MRI can serve as stronger predictive tools.
🔬 Study Design
This was a pre-specified substudy of the MOTILITY trial, a prospective multicenter cohort study conducted across 13 UK hospitals.
Patients with active, non-stricturing small bowel Crohn’s disease undergoing anti-TNFα or anti-IL-12/23 therapy were enrolled. They received MRE with DWI at baseline and again post-induction (12–30 weeks). The key aim was to determine whether early imaging changes could predict clinical response or remission (RoR) at ~1 year.
📈 Key Findings
- A >10% increase in apparent diffusion coefficient (ADC) post-induction was associated with higher likelihood of long-term RoR.
- A >25% decrease in the modified Clermont score also predicted better outcomes.
- These imaging markers outperformed traditional clinical predictors like CRP and calprotectin.
📌Conclusion
DWI MRI offers valuable, non-invasive biomarkers for forecasting long-term response to biological therapies in Crohn’s disease. Incorporating these imaging tools may help personalize treatment and improve patient care.
📖 Read the Full Article
Click here to access it on BJR →
📣 Join the Conversation
We’d love to hear what you think about this study. Could DWI MRI become a standard assessment tool in inflammatory bowel disease? Share your thoughts or questions with us.
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